METABOLISM IN THE STOMACH AND INTESTINES G27 



The succus entericus possesses two important ferments : 



(a) Enterokinase which renders trypsin active. 



(b) An amylolytic ferment, which can invert cane sugar and 

 convert maltose into dextrose. 



These ferments are essential for normal digestion. To what extent, 

 impairment of their functioning influence the metabolism of the body 

 is unknown. Certain it is that pepsin and erepsin can carry on the further 

 digestion of proteins in the absence of trypsin, but only to a limited degree, 

 as shown by the high protein content of the feces in marked grades of 

 pancreatic insufficiency. How serious absence of the amylolytic ferment 

 would be is a matter of conjecture, especially when we consider that the 

 pancreatic juice itself and the saliva contain a ferment for the digestion 

 of carbohydrates. 



The bile, the pancreatic juice and the succus entericus then are in- 

 timately connected with the intestines in their various functions. De- 

 rangements may occur, primary in the organs elaborating these digestive 

 juices and the intestines be secondarily affected, and through both, the 

 metabolism influenced. Or the process initiating the disease may be 

 primary in the intestines and the above considered secretions be second- 

 arily affected. It is difficult to assign to any one of the secretions its 

 exact role in the causation of the metabolic complications. Rather these 

 secretions must be considered as a whole, by their combined functions 

 regulating digestion and thereby having a definite influence upon the 

 metabolism of the body. 



Equally as important as the secretory functions is the motor activity 

 of the intestines. Disturbances in the propulsion of the intestinal con- 

 tents are associated often with striking intestinal upsets, which react 

 to varying degrees upon the body metabolism. For absorption to be nor- 

 mal, the motor activity of the intestines must not be much deranged. 

 Increased peristalsis perhaps interferes more with the proper absorption 

 of foodstuffs than does delay in motility, unless the latter be very great 

 and associated with either obstruction or very marked constipation. The 

 extreme length of the intestines and its large absorptive surface permit 

 fairly complete absorption of foodstuffs, in the presence of a moderate 

 degree of hypermotility. Also the fact that the colon, under stress, can 

 to a certain extent increase its role of absorption, gives the intestines a 

 considerable power of protecting the body from deficient absorption. 

 However, marked grades of hypermotility occur where the foodstuffs are 

 so rapidly propulsed through the intestines that particles of food appeal' 

 undigested in the feces a few hours after they have been taken by mouth. 

 Such a condition may be met with in some of the achylia gastricas ^ and 

 naturally the nutrition of the body suffers markedly in such conditions. 



Delayed motility of the intestines such as occurs in spasms, stenosis, 



